胃と腸40巻1号

2005年01月発行

今月の主題 胃癌の時代的変遷と将来展望 主題

胃癌に対する化学療法，集学的治療の現状と将来

著者： 中島聰總¹ 山口俊晴¹ 大山繁和¹ 瀬戸泰之¹

所属機関： ¹癌研究会附属病院消化器外科

ページ範囲：P.94 - P.104

要旨　西欧諸国とわが国の研究を対照させながら，胃癌に対する化学療法，集学的治療の現状をreviewした．西欧における進行胃癌に対する化学療法では1979年のFAM療法以来，FAMTX，EAP，ELF，PELF，ECF，DCFなどの治療法が標準治療として検討されてきたが，現時点ではECFまたはDCFが標準治療とみなされている．他方わが国ではS-1，Taxane，CPT-11などの新しい薬剤を中心に高い奏効率と生存期間の延長が報告されたが，これらのregimen相互間の評価は今後の検討に委ねられている．いずれはglobal standardをめざして，西欧とわが国のregimenの比較対照試験が必要である．これらの臨床試験を反映して術前化学療法も高い奏効率が報告されているが，今後延命効果からみた評価が必要である．術後補助化学療法として，Macdonaldらの化学放射線療法の有意の延命効果が報告されたが，これをわが国の標準治療として導入するには種々の問題点がある．

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